Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis: a prospective cohort study in Belgium (2016–2020)

Geebelen, Laurence; Lernout, Tinne; Devleesschauwer, Brecht; Kabamba-Mukadi, Benoît; Saegeman, Veroniek; Belkhir, Leïla; Munter, Paul De; Dubois, Bénédicte; Westhovens, René; Giot, Jean-Baptiste; Léonard, Philippe; Vangheluwe, Riet; Wieërs, Grégoire; Marot, Jean-Christophe; Evrard, Frédéric; Delaere, Bénédicte; Noirhomme, Séverine; Binnemans, Els; Vanhoof, Johan; Oyen, Herman Van; Speybroeck, Niko; Tersago, Katrien

doi:10.1186/s12879-022-07686-8

Cited by 11 publications

(16 citation statements)

References 66 publications

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“…Similar to our study, van den Wijngaard et al (2017) estimated LB costs for the Netherlands, including direct medical and indirect nonmedical costs [28]. For EM, a mean ambulatory cost of €136 was estimated (amount adjusted to 2019 price level [29,30]), which is lower than our mean estimate of €193 in EM patients (including 5.9% patients with PTLDS [31]). Note that in contrast to the Dutch study, our study included OTC medication, laboratory testing and travel expenses with a cost of €40.…”

Section: Discussionsupporting

confidence: 73%

“…It is important to note that, in the current study, only costs for patients with clinical LB manifestations, either EM or laboratory confirmed disseminated/late LB, were included [31]. As such, costs for consultations for a tick bite without LB development were not counted even though they might take place due to worries about LB.…”

Section: Discussionmentioning

confidence: 99%

“…The cohorts were followed up and patients who developed PTLDS were identified based on the case definition proposed by the Infectious Disease Society of America (IDSA) [3]. The results of the PTLDS analysis are published elsewhere [9]. A total of 108 EM patients and 15 disseminated/late LB patients, prospectively recruited for the PTLDS baseline analysis, were included in the current cost analysis.…”

Section: Direct Medical Costs Ambulatory Carementioning

confidence: 99%

“…Six EM and three disseminated/late LB patients fulfilled the complete PTLDS definition. Three EM patients and two disseminated/late LB patients had a missing value for PTLDS, and the information for these cases was imputed [9]. Since for each of these patients, either all imputations or the majority of the imputations led to the conclusion of "no PTLDS", these five patients were assigned to the "no PTLDS" groups for the purpose of our analysis.…”

Section: Direct Medical Costs Ambulatory Carementioning

confidence: 99%

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Lyme borreliosis in Belgium: a cost-of-illness analysis

et al. 2022

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Background Lyme borreliosis (LB) is the most common tick-borne disease in Europe and North America, yet its economic burden remains largely unknown. This study aimed to estimate the economic cost associated with the different clinical manifestations of LB in Belgium. Methods An incidence approach and societal perspective were used to estimate the total cost-of-illness for LB in Belgium. Costs were calculated for patients with erythema migrans (EM) or disseminated/late LB, including patients who developed post-treatment Lyme disease syndrome (PTLDS). Direct medical, direct non-medical (transportation & paid help) and indirect non-medical costs (productivity losses) were included in the analysis. Ambulatory cost data were collected through a prospective cohort study from June 2016 to March 2020, in which patients with LB were followed up 6 to 12 months after diagnosis. Hospitalization costs were retrieved from the Minimal Clinical Data registry, a mandatory registry for all Belgian hospitals, linked to the Minimal Financial Data registry. Costs were expressed in 2019 euros. Results The total annual cost associated with clinical manifestations of LB in Belgium was estimated at €5.59 million (95% UI 3.82–7.98). Of these, €3.44 million (95% UI 2.05–5.48) or 62% was related to disseminated/late LB diagnoses and €2.15 million (95% UI 1.30–3.26) to EM. In general, direct medical costs and productivity losses accounted for 49.8% and 46.4% of the total costs, respectively, while direct non-medical costs accounted for only 3.8%. The estimated mean costs were €193 per EM patient and €5,148 per disseminated/late LB patient. While patients with PTLDS seemed to have somewhat higher costs compared to patients without PTLDS, the number of patients was too small to have representative estimates. Conclusions We estimate the total annual direct medical costs, direct non-medical and indirect non-medical costs associated with LB to exceed €5.5 million per year, almost evenly distributed between EM (40%) and disseminated/late LB (60%). EM costs 26 times less per patient but occurs also 16 times more frequently than disseminated/late LB. The cost burden remains limited by comparison to other infectious diseases due to the relative lower incidence.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Direct Medical Costs Ambulatory Carementioning

confidence: 99%

Section: Direct Medical Costs Ambulatory Carementioning

confidence: 99%

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Lyme borreliosis in Belgium: a cost-of-illness analysis

et al. 2022

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“…Post-treatment Lyme disease syndrome (PTLDS) is diagnosed in up to 20% of patients treated for Lyme disease. 21 PTLDS is a clinical diagnosis for a patient who experiences continued or relapsing symptoms for at least 6 months after being treated for Lyme disease. The most common symptoms are pain, fatigue, and/or diffi culty thinking.…”

Section: Post-treatment Lyme Disease Syndromementioning

confidence: 99%

Early identification of Lyme disease complications

Eckenrode¹

2023

Jaapa

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migrans rash, which is often described as a localized annular lesion with central clearing (Figure 1). 6 During early disseminated disease, the patient may experience a constellation of symptoms including fever, headaches, fatigue, myalgia, facial nerve palsies, and cardiac or neurologic complications (Table 1). 1,5 If left untreated, Lyme disease can lead to a variety of different complications including Lyme arthritis, Lyme carditis, and Lyme neuroborreliosis. Up to 60% of patients with untreated early Lyme disease will develop Lyme arthritis. 5 Lyme arthritis typically is manifested during late disease and can occur weeks or even months after the initial tick bite. 5 Between 4% and 10% of patients with untreated Lyme disease will develop Lyme carditis, which is most commonly seen in patients ages 10 to 45 years. 1,4 Lyme neuroborreliosis is less common in the United States than in Europe, and about 11% of patients with Lyme infection present with neurologic symptoms. 7 LYME ARTHRITISLyme arthritis is the most common complication of late Lyme disease and often presents as monoarthritis of the knee weeks or months after the initial tick bite. 5 It also can present as asymmetric oligoarthritis, most often of the large joints (Table 2). Lyme arthritis is caused by vascular damage, cytotoxic processes, proliferation of fi broblasts, and fi brosis in the joint in response to a proinfl ammatory © DAVID JARA BOGUNYA/SHUTTERSTOCK.COM I n the United States, Lyme disease, a tick-borne illness, is most commonly caused by the spirochete bacteria Borrelia burgdorferi. 1 Although about 30,000 cases are reported each year in the United States, the actual incidence of Lyme disease is about 476,000 cases annually, with most cases occurring in the Northeast and upper Midwest. 2 A missed diagnosis of Lyme disease can lead to a variety of systemic complications and increase patient morbidity and mortality.The incubation period of Lyme disease ranges from 3 to 30 days, with an average of 7 to 14 days. 3 Lyme disease is more common in males and typically follows a bimodal age distribution, occurring most commonly in children ages 5 to 9 years and adults ages 45 to 59 years. 4 The three stages of Lyme disease are early localized, early disseminated, and late disease. 5 In early localized disease, about 80% of patients will experience the classic erythema ABSTRACT Complications of Lyme disease including Lyme arthritis, Lyme carditis, and Lyme neuroborreliosis, typically occur during the early disseminated and late phases of the disease. Clinicians must maintain a high index of suspicion so they can recognize and treat complications promptly. Early treatment with appropriate antibiotics often leads to improved clinical outcomes.

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Mitochondrial dysfunction in long COVID: mechanisms, consequences, and potential therapeutic approaches

Molnar,

Lehoczki,

Fekete

et al. 2024

GeroScience

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The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has introduced the medical community to the phenomenon of long COVID, a condition characterized by persistent symptoms following the resolution of the acute phase of infection. Among the myriad of symptoms reported by long COVID sufferers, chronic fatigue, cognitive disturbances, and exercise intolerance are predominant, suggesting systemic alterations beyond the initial viral pathology. Emerging evidence has pointed to mitochondrial dysfunction as a potential underpinning mechanism contributing to the persistence and diversity of long COVID symptoms. This review aims to synthesize current findings related to mitochondrial dysfunction in long COVID, exploring its implications for cellular energy deficits, oxidative stress, immune dysregulation, metabolic disturbances, and endothelial dysfunction. Through a comprehensive analysis of the literature, we highlight the significance of mitochondrial health in the pathophysiology of long COVID, drawing parallels with similar clinical syndromes linked to post-infectious states in other diseases where mitochondrial impairment has been implicated. We discuss potential therapeutic strategies targeting mitochondrial function, including pharmacological interventions, lifestyle modifications, exercise, and dietary approaches, and emphasize the need for further research and collaborative efforts to advance our understanding and management of long COVID. This review underscores the critical role of mitochondrial dysfunction in long COVID and calls for a multidisciplinary approach to address the gaps in our knowledge and treatment options for those affected by this condition.

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Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis: a prospective cohort study in Belgium (2016–2020)

Cited by 11 publications

References 66 publications

Lyme borreliosis in Belgium: a cost-of-illness analysis

Lyme borreliosis in Belgium: a cost-of-illness analysis

Early identification of Lyme disease complications

Mitochondrial dysfunction in long COVID: mechanisms, consequences, and potential therapeutic approaches

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